Greg Grindley will tell surgeons how he feels as they carefully thread electrodes deep into his brain this weekend, attempting to reverse symptoms of his Parkinson's, a disease that freezes his face and sets his hands trembling.
The 49-year-old Ohio electrician will be awake for the surgery, known as deep brain stimulation, and his reactions will help guide lead surgeon Jonathan Miller in placing the four electrodes. While Grindley answers questions from the medical team, doctors will answer questions from viewers watching the procedure on live television. (You can ask ask on Twitter at #brainsurgerylive.)
Brain Surgery Live with Mental Floss will air on Sunday at 9 p.m. ET on the National Geographic Channel, marking the first time brain surgery has been broadcast live in the U.S. If all goes well, Grindley will soon gain more control over his movements and will be able to cut back on medication.
Miller, director of Functional and Restorative Neurosurgery at Ohio's University Hospitals Case Medical Center, where the surgery will happen, talked to us about about how deep brain stimulation works and why he’ll operate on TV.
Are you anxious about doing this surgery on live television? What if you make a mistake?
This is not a truly cutting-edge procedure. We do it every week.
So why televise it?
A lot of people aren’t aware that we have these therapies available and a lot of patients suffer needlessly. Our goal is to publicize the problem and the solution.
Are there any moments in surgery that might be tough to watch for people who are squeamish?
The cut’s about an inch long, using a drill to make a little hole in the skull. That’s easy to say, but not having seen that sort of thing before, that could be a little bit… there’s not a lot of blood or brain exposure. It probably won’t be too bad.
How useful is deep brain stimulation for Parkinson’s and essential tremors, which can leave people with shaky hands?
For the right kind of tremor, if you get the electrode in the right place, it’s as close to a guaranteed result as you can get. Even if you get a little bit [of improvement], it can make a huge difference in the patient’s quality of life.
For Parkinson’s, it depends on the patient and on the disease. If their disease gets better with medication, it tends to get better with DBS, too.
Those are the only two uses the Food and Drug Administration has approved for deep brain stimulation. Are more possibly coming?
Some of the obvious ones would be pain, emotional and psychiatric problems, cognitive problems, obesity, tinnitus, Tourette’s. But we’re still a long way from prime time for any of those.
What’s the hardest part about convincing someone to get this procedure?
For a lot of those with tremor, especially those who’ve had it for a long time, one of the difficult things is getting them to realize how disabling their tremor is. They develop so many compensatory ways of living their life. They say, "I just can’t drink from a cup. I can’t use a fork in a restaurant. It’s just not something I do."
They’ve forgotten what it’s like to not to be sick. A big part what it is we do is showing them that a better life is possible.
Are all Parkinson’s patients good candidates for this deep brain stimulation surgery?
DBS may actually alter the course of Parkinson’s early on. [But] there's only a certain period of time when DBS is going to help. For people who have a particularly fulminant form of the disease, the window can close pretty quickly. If you get them too late, it may be to the point where they're not going to benefit from DBS anymore.
What do you hope the surgery will do for Greg Grindley?
Side effects of medication are a big part of his problem. Whenever he gets medication all his symptoms get a lot better. Initially, it was miraculous. He'd take the medication, the tremors would go away.
But then the body gets used to it. Eventually, he required more and more and the side effects became debilitating. We’d give him smaller doses more often: He was taking it every 6 hours, then every 4 hours. Now, literally every 2 hours while he's awake.
He’s moving too much. A few minutes later he’ll be frozen with this terrible tremor. He’ll take his medication. He’ll move too much again.
We’re not going to get him better than his best response on medication, but we're going to smooth it out, so he's always on his best—so he's not on that roller coaster.
Right now, you implant electrodes to directly stimulate nerves and improve people’s motor control. What will the next generation of deep brain stimulation look like?
We’re going to see new [technologies] that can record what’s going on in the brain and change the stimulation dynamically based on what it’s hearing, or look at the neuro-chemical environment to figure out what’s going on or even alter that environment by letting small amounts of drug out; possibly using light to change how nerves work, or changing temperature, so you would have a refrigerated lead [or electrical wire] to make nerves function differently.
What turned you on to this kind of work in the first place? Why did you become a brain surgeon?
When I found it was possible to restore brain health by actually being able to do something about it, I was hooked. There’s nothing you can compare to giving someone their life back.
This interview has been edited and condensed. Follow Karen Weintraub on Twitter.